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I’d like to share a recent e-mail I received from someone named Michael Gostowski, a reader who evidently loathes me, my blog and the entirety of WNYMedia.net. Also, black people. Aside from breaking this into a couple of paragraphs to make reading easier, the grammar was left as originally sent to convey the sheer lunacy of the communication:

hey socialist fuckass,
ive been reading your blog for around a year now. I know who you are and ive heard you on the radio talking your socialist commie shit. what the fuck is wrong with you? says on your blog that your a veteran and your brohter still serves in the middle east. how can you support a muslim president who would rather see your brother die in the desert than have them fight for liberty and the safety of real americans?

and how can you get behind this socialist reform bill that takes away your american rights given by god? when george washington wrote the constitution, he wasn’t kidding when he said this would be a christian country with presidents born in this country. if he wanted a socialist country, he would have written the constitution to say we were a bunch of socialist faggots who are willing to give away half our money to lazy thieving people who would rather pump out kids, collect welfare and live off the sweat of my brow. now, these people will get free healthcare, i’ll be forced to pay for it and i’ll have to go to jail if i dont. how is that america?

the founding fathers would be ashamed of what we’ve become and blogs like yours make it seem as if your not part of the liberal media elite but you are and your hurting your country by propping up this illegitmate president who has us on a march to communism. i dont know how you can look yourself in the mirror knowing that you support a man who wants your brother to die and wants to take away our rights. the elections this year will be a reckoning and we will be taking our country back from socialist scum like barry sotero and you. enough is enough.

Well, that was fun. I almost don’t even know where to begin.

Let’s start with the whole “Obama is a socialist” and “the health care bill is socialism” thing, shall we? Here’s a statement I received from the Socialist Party USA on the healthcare bill, ya know, because I’m a member of the liberal media elite:

March 22, 2009 – Co-chair of the Socialist Party USA, Billy Wharton, opposes the healthcare bill passed yesterday by the House of Representatives and scheduled to be signed into law by President Barack Obama on Tuesday. Wharton’s opposition is based on the belief that this bill is not a reform. Instead, it is a corporate restructuring of the health insurance industry created to protect the profit margins of private insurance companies.

The bill passed by the House yesterday would mandate all Americans to purchase health insurance coverage or face a fine. It would also create health insurance exchanges, an idea crafted by the right-wing Heritage Foundation, where people would purchase insurance from private companies.

Those not eligible for Medicaid but who still could not afford to purchase insurance would receive public funds from the federal government to purchase bare bones coverage insurance plans from private insurers.

Wharton opposes this restructuring on the grounds that the mandates allow private insurers to use the coercive power of the state to enhance their private profits. Insurance credits will serve as a public subsidy to private companies. It is yet another case of public money that could be used for necessary social programs being funneled towards companies that engage in practices that are abusive and detrimental to the overall society. He believes the bill is also a demonstration of how deeply corporate lobbyists and campaign contributions have infected the country’s political system.

“This is not a healthcare reform bill,” says Wharton, “It is instead a corporate restructuring of the American healthcare system designed to enhance the profits of private health insurance companies disguised with the language of reform.”

So, yeah, I think we can move on.

Here’s a pop quiz, what reform was originally conceived by Richard Nixon, advocated for by the Heritage Foundation in the 1980’s, written into the Republican counter proposal to Hillary’s health reform bill in 1994, advocated for by Newt Gingrich, put in place in Massachusetts by then Governor Mitt Romney and supported by Tea Party hero Scott Brown? A health insurance mandate, also called a “personal responsibility principle” by Mitt Romney back in 2006. Now? “SOCIALISM TYRANNY ZOMG THEY’RE COMING FOR OUR LIBERTY AND GUNZ!”

Starting in 2014, the new law will require nearly all Americans to have health insurance through an employer, a government program or by buying it directly. That year, new insurance markets will open for business, health plans will be required to accept all applicants and tax credits will start flowing to millions of people, helping them pay the premiums.

Conservatives today say that’s unacceptable. Not long ago, many of them saw a national mandate as a free-market route to guarantee coverage for all Americans — the answer to liberal ambitions for a government-run entitlement like Medicare. Most experts agree some kind of requirement is needed in a reformed system because health insurance doesn’t work if people can put off joining the risk pool until they get sick.

Enough with all of this socialism nonsense. We’re not even close to being a socialist state, much to the chagrin of several WNYMedia bloggers. Claims that we are “marching towards socialism” are all politics, not principle. Smarten up, dummies.

The “founding fathers” would be ashamed to learn that their great Republic now features 40% of the populace fighting on behalf of corporations to maintain their right to fuck the people over without consequence.

Also, next time someone wants to question my patriotism, he or she can kiss my liberal ass.

I have not enabled comments because I’m not interested in yet another round of mindless libertarian regurgitations stolen from writers at Lew Rockwell and Cato. Get your own blog.

In the lead up to the passage of the historic health insurance reform bill, there wasn’t a lot of thorough and fact-based coverage about the actual legislation. Sure, there were frequent updates on the political horse race, who won or lost the daily news cycle, debunking of death panel nonsense and Freedom Works talking points, documenting outrage, etc., but not much straightforward coverage on the individual components of the bill. Think that may have influenced the national debate? Maybe that’s why individual components of the bill polled well, while the bill as a whole did not.

Funny how the day AFTER the bill passed, the big media outlets lined up with thorough infographics, interactive timelines, bullet-point lists of legislative benefits, multimedia presentations and information about how the bill will effect YOU, Joe Citizen.

It would have been nice if they had contributed this type of coverage DURING the debate, not after. We might have had a substantive national discussion about our healthcare priorities. Instead, we got editorial page drivel and the daily butcher’s bill on transactional bullshit.

Now that healthcare reform has passed the House and the conversation is turning from ZOMG SOCIALISM DEATH PANELS@$!#! to more pleasant discussions about what’s actually in the bill, we thought it would be a good idea to post the ten immediate benefits people will receive when the bill formally becomes law.

The legislation will:

Prohibit pre-existing condition exclusions for children in all new plans

Provide immediate access to insurance for uninsured Americans who are uninsured because of a pre-existing condition through a temporary high-risk pool

Prohibit dropping people from coverage when they get sick in all individual plans

Lower seniors prescription drug prices by beginning to close the donut hole

Offer tax credits to small businesses to purchase coverage

Eliminate lifetime limits and restrictive annual limits on benefits in all plans

Require plans to cover an enrollee’s dependent children until age 26

Require new plans to cover preventive services and immunizations without cost-sharing

Ensure consumers have access to an effective internal and external appeals process to appeal new insurance plan decisions

Require premium rebates to enrollees from insurers with high administrative expenditures and require public disclosure of the percent of premiums applied to overhead costs

By enacting these provisions right away, and others over time, the government will be able to lower costs for everyone and give all Americans and small businesses more control over their health care choices.

President Obama’s closing argument on the healthcare reform bill, given yesterday to the House Democratic Caucus in the Capitol Visitor Center.

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Every once in a while, every once in a while…a moment comes where you have a chance to vindicate all those best hopes that you had about yourself, about this country, where you have a chance to make good on those promises you made in all those town meetings and all those constituency breakfasts and all that traveling through the district, all those people who you looked in the eye and you said, you know what, you’re right, the system is not working for you and I’m going to make it a little bit better.

Honest debate on healthcare reform has been hard to come by primarily because the opposing sides are playing different games. Democrats are playing Jeopardy and Republicans are playing Family Feud. One game is based on facts, the other is based on the top answers of 100 uninformed morons.

However, there is an honest, intellectual debate amongst centrist and leftist writers. We see the bill for what it is, regulation of an existing marketplace. Those on the left see it as a giveaway to the insurance companies, while centrists (or those resigned to the fact that this is the best bill our current system can shit out) are fine with the moderate incremental regulations.

Those on the right? Yeah, they’re having an entirely different debate and it’s not grounded in reality. It’s misinformed and generally motivated by one of the Four Horsemen of the Conservative Movement; Fear, Rage, Greed, and Ignorance.

Am I painting with a broad brush? Absolutely. Do I care? Not really. “Moderate” Republicans or “Intellectual” Conservatives or Praxeologists share the same emotional motivations as the angry tea party loyalists who protested on Capitol Hill yesterday. The only difference is in how they show it.

New Left Media did one last video featuring interviews with protesters and it was well done, respectful and pretty revealing.

I’ve negotiated with my inner Kucinich and made peace with the health insurance reform bill. It’s time to finish the job.

By the way, a couple of points on the status of the bill and the reporting I’ve seen/read on the remainder of the process. It’s important to note that we’re not “passing” healthcare reform through reconciliation. The bill(s) already “passed” with the required votes in both houses, a majority in the House and 60 votes in the Senate. Now, the House will pass the Senate bill and changes which affect the budget will be applied through reconciliation, a valid and well used procedure. That’s it. The big commie muslim socialist black man will not be (c)ramming his big black reform plan down anyone’s throat. Language matters. I digress…

The bill is not perfect and it is not what I wanted it to be when the process began and it is a product of a very flawed system. However, it is the first step toward real, long-term reform in our healthcare system. Incrementalism is the reality in our corporate political world until the bright shining day arrives when money is taken out of politics.

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We’ve listened to what FreedomWorks, AHIP, PhRMA, and the rabid teabaggers had to say. The bill has been watered down to the point where progressives barely recognize it anymore. The Democrats adopted 161 of 201 proposed GOP amendments to the Healthcare bill and did not receive one single affirmative GOP vote as a reward for their compromises.

The final Senate bill includes all four planks of the GOP’s proposed alternative plan, including buying insurance across state lines, tougher medicaid/medicare fraud prevention strategies, empowerment for states to implement the plan in different ways, tort reform and purchasing pools for small business. It’s all in the bill.

In fact, one could say that this bill combines the best parts of the GOP plan and the worst of the Democratic plan. Primarily, it lacks a public option, single payer provisions and is entirely based on regulating the private market. It is possible that a public option could be brought back into the bill through reconciliation with 41 Senators now signed on to support that effort (including Schumer and Gillibrand), but I won’t hold my breath.

Since the Democrats would not receive one single, solitary vote no matter what bill they put forward, I thought they should have simply pushed forward a bill with a robust public option and the regulations needed to make an immediate impact on the system. However, the will was lacking in the Democratic Party as many of the legislators are just as indentured to the insurance and medical lobby as their counterparts on the right.

So, the bill we have is the one the system is willing to give us at this point. With a minority party more interested in opposing then governing, this is what happens. When Democratic Senators are operating as lobbyists for Wellpoint, UHC and Aetna, this is what we get. As is often said nowadays, it is what it is. My hope is that once this bill is put in place, further reforms will be enacted, market protections will increase, coverage will be expanded and we’ll eventually end up with a more perfect healthcare system. Perhaps the Democrats might embrace a simple four page bill that should have been the starting point for this reform process. To stop now simply guarantees that nothing will be done.

I chose the “We are the ones we’ve been waiting for” video from the Obama campaign because it was a seminal moment in a historic campaign. Whatever you thought of Obama then or whatever you think of him now, he speaks truth in that clip. Change and reform are only possible if we advocate for it, fight for it, demand it. If we push our legislators to demand better, more and faster. Perhaps the grassroots on the left was disenfranchised from the start and were drowned out by the astroturf millions on the right during the formative portions of this process. Perhaps the monied interests have a bigger ownership stake in our legislators than we do, but we have what we have.

1) If healthcare is such a priority now, how does it help to have most provisions of the current bill not start until 2014, and to not try to pay for it until 2018?

2) Speaking of which, if the costs are such a problem, how does it help that the plan is modeled on Massachusetts, where coverage is expanded but the state’s healthcare premiums are skyrocketing?

3) If Medicare is underfunded, how does it help that $500B comes out of its budget?

4) If insurance company profits are the problem, how does it help to mandate insurance and let insurance company profits go up?

Note that I have not used the words “Democrat” or “Republican” is any question, so if the answers could not contain the phrases “Its all Bush’s fault” or “The Republicans want Obama to fail” I’d appreciate it. KTHX.

I’m always amused by the constant Nixonian drumbeat from the right about the dastardly “liberal media”. Of course, said “liberal media” breathlessly covers right wing protests and faux right wing populism, relying upon useful myths and confirmation bias as major elements of the storytelling toolkit. We don’t have a “liberal media”, we have a “lazy corporate media”. If you don’t know the difference between the two, I don’t really know what to tell you.

Here’s something, the “liberal media” didn’t give an ounce of coverage to, a protest featuring actual liberals demanding healthcare reform. Remember how many of these protests you saw featured on the news this past year? Yeah, keep thinking…

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“1000s of New Yorkers walked across the Brooklyn bridge as a rally for a public option on Saturday and went onto the headquarters of Wellpoint. No TV outlet covered the event – probably because it wasn’t called a tea party. Well here are the photos from the event.”

Citizen Action can barely get a mention in the media when they bring hundreds or thousands of people out for a progressive rally. Maybe they need a national cable news outlet to organize, plan and market it for them…

That screaming throng of morons has informed the debate on healthcare to an alarming level. I like to call it the triumph of the dumb.

The following table combines two sets of questions from the Kaiser survey, each of which ask people about the individual components of the bill. One set of questions asks people whether they believe that the bill contains each provision; the other set, which I’ve tabulated on a net basis, asks them whether they’d be more or less likely to support a bill if it contained such a provision.

What we see is that most individual components of the bill are popular — in some cases, quite popular. But awareness lags behind. Only 61 percent are aware that the bill bans denials of coverage for pre-existing conditions. Only 42 percent know that it bans lifetime coverage limits. Only 58 percent are aware that it set up insurance exchanges. Just 44 percent know that it closes the Medicare donut hole — and so on and so forth.

“Awareness”, by the way, might be a forgiving term in this context. For the most part in Kaiser’s survey, when the respondent doesn’t affirm that the bill contains a particular provision, he actually believes that the bills don’t include that provision. 29 percent, for instance, say the bill does not contain a provision requiring insurers to cover those with pre-existing conditions; 20 percent think it does not expand subsidies.

How would public opinion change if people were fully informed about the content of the bills? It’s hard to say for sure, but on average, the individual components of the bill are favored by a net of +22 points. An NBC poll in August also found that support went from a -6 net to a +10 when people were actually provided with a description of the bill.

What you see here is the result of a massive misinformation campaign launched by industry lobbyists, astroturf activists and monied interests. People who were sketchy on the idea of government led healthcare reform were completely swayed without an intellectually honest discussion about the merits of the bill. This chart shows the inability of this President to communicate his agenda clearly and for the Democrats to effectively legislate this vital and central piece of their agenda. FAIL all around.

Then there’s the problem of rising cost. We spend one and a half times more per person on health care than any other country, but we aren’t any healthier for it. This is one of the reasons that insurance premiums have gone up three times faster than wages. It’s why so many employers — especially small businesses — are forcing their employees to pay more for insurance, or are dropping their coverage entirely. It’s why so many aspiring entrepreneurs cannot afford to open a business in the first place, and why American businesses that compete internationally — like our automakers — are at a huge disadvantage. And it’s why those of us with health insurance are also paying a hidden and growing tax for those without it — about $1,000 per year that pays for somebody else’s emergency room and charitable care.

When he uttered the underlined portion of the address, I hoped he would expand on it and make it a central pillar of the healthcare reform cause. After all, making businesses more competitive while expanding coverage appeals to most interest groups. However, this sentence was all we got in the speech and the debate became a race to the bottom with words like socialism, fascism and corporatism thrown about by the chattering class and the masses.

I’ve always thought that a very simple way to explain the need for comprehensive healthcare reform would be to explain that employers should not be responsible for bearing the burden of employee healthcare. It’s an anachronism and we’re about to codify it in law for a very long time.

Once upon a time in America, employers needed to offer health insurance as an incentive for an employee to join his/her firm. Over the years, unions demanded health care from their employers and non-union shops offered benefits to their employees as well. Since health insurance wasn’t a large cost, it made sense for employers to keep their employees healthy (read: well enough to work) and offer an incentive to keep employee turnover to a minimum. That’s the shortest version of why your employer provides healthcare that I can give without delving into a 10,000 word post on the matter. Let’s just assume we’re all educated enough to see the big picture, agree on this general framework and move on.

In 2010, employer-provided healthcare has essentially been codified into our socioeconomic system by law and regulation. As healthcare costs have risen dramatically over the past two decades, employers have shouldered a large burden of the cost. Providing healthcare to employees can be viewed as a disincentive for companies to hire, grow and invest in their workforce. It limits profit margins for US based companies which compete in the global marketplace as most other indutrialized nations offer some form of socialized care. There is a reason that GM has expanded its factory footprint in Canada (with full union membership) while closing factories in the US.

Employer-provided healthcare also limits flexibility for employees. Leaving one job for another or making professional career changes may result in the loss of health insurance. It also limits available healthcare options for employees who may want more or less coverage than their employer offers. Worst of all, it hides the true cost of healthcare from the consumer and provides poor value and diminishing returns to those in the system.

So, limited choice, rising costs, overconsumption of services and poor value are the legacies of this employer-centric model of health insurance. What Obama and the Democrats have done with the current healthcare bill is essentially implement an individual mandate for insurance, thereby increasing the risk pool while also implementing some moderate reforms on the manner in which insurance companies must deliver the insurance (prohibiting recision, killing lifetime maximums, increasing preventive care). They have eliminated adverse selection in the system, but have they done nothing to fundamentally alter the flawed employer-centered delivery mechanism or the cost centers for businesses. Until the delivery system is changed, we are not only doing little to reduce costs, we are doing nothing to free employers from the burden of providing healthcare.

There are two ways to fix that problem, one is to standardize a universal, single-payer system and the other is to establish a market wherein individuals are mandated to buy coverage but must choose from an array of regulated offerings. I’m a standardized, universal man myself, but I’m also interested in the Swiss or German or Swedish models.

We have chosen to do neither in this “reform” process and the likelihood of a bill passing which appeals to anyone but the health insurance lobby grows smaller every day. The irony of the process is that the right wing teabag movement decries “government takeover” and ‘islamofascosocialism” at every opportunity while overlooking the fact that the PhRMA, AHIP and the rest of the insurance lobby is quite happy with the outcome. The left ignores much of the benefits contained in the new industry regulations which expand/protect access because the bill is too much of an industry giveaway. No one is happy. It’s not compromise if both parties walk away from the negotiating table feeling as if they were f’d in the a.

I can’t but help think that if the President had treated Americans like adults from the start and set the tone for the debate in a way that focused on the benefits of removing the responsibility for health insurance from our employers, that we would be in a much different position.

The United States spent 16 percent of its GDP in 2008 on healthcare, higher than any other developed nation. The nonpartisan Congressional Budget Office (CBO) estimates that number will rise to 25 percent by 2025 without changes to federal law (PDF). Employer-funded coverage is the structural mainstay of the U.S. health insurance system. According to the U.S. Bureau of Labor Statistics, about 71 percent of private employees in the United States had access to employer-sponsored health plans in 2006. A November 2008 Kaiser Foundation report says access to employer-sponsored health insurance has been on the decline (PDF) among low-income workers, and health premiums for workers have risen 114 percent in the last decade (PDF). Small businesses are less likely than large employers to be able to provide health insurance as a benefit. At 12 percent, healthcare is the most expensive benefit paid by U.S. employers, according to the U.S. Chamber of Commerce.

Some economists say these ballooning dollar figures place a heavy burden on companies doing business in the United States and can put them at a substantial competitive disadvantage in the international marketplace. For large multinational corporations, footing healthcare costs presents an enormous expense. General Motors, for instance, covers more than 1.1 million employees and former employees, and the company says it spends roughly $5 billion on healthcare expenses annually. GM says healthcare costs add between $1,500 and $2,000 to the sticker price of every automobile it makes. Health benefits for unionized auto workers became a central issue derailing the 2008 congressional push to provide a financial bailout to GM and its ailing Detroit rival, Chrysler.

Is it too late to change the framework for this debate in order to center the discussion on the burdens we place on business? If healthcare reform in its current incarnation were to fail, re-igniting the debate around this central pillar might be a way to begin the conversation anew and focus the debate on policy. Think of what GM could do if they were relieved of that $5BN annual cost? Would they be able to expand their workforce, raise compensation levels, invest in innovation, re-tool factories, expand to new markets? Absolutely.